Abstract
Objective: Our hospital has carried out a screening test for HIV infection in preoperative patients and pregnant women since 1994. In 1999, when the first HIV-positive case was found, no manual was available to guide administrative management of such cases; great confusion occurred among the hospital staff. We restored an orderly approach to the problem and prepared a manual. Our measures were very effective, so we felt that reporting our experience could be helpful.
Materials and Methods: From April 1994 to March 2003, seven putative positive cases were discovered. We examined problems in assessment of results, reporting of results to physicians and nurses and notification of affected patients.
Results: Screening was done in 16, 739 patients, of whom 7 (0.04%) were positive by enzyme immunoassay; EIA. On definitive testing, 2 EIA-positive results were found to be false, leaving 5 confirming positive cases (0.03%). After analysis of the problems, procedures were formulated and implemented. When a HIV-positive case is confirmed, the result is reported directly to the physician in charge of HIV infection management, who contacts the patient's physician and the nurses in charge of HIV infection control. These staff members notify and advise the patient together. Since the manual has been distributed, major confusion never has occurred.
Conclusion: Implementing procedures specified in our manual was very helpful in managing positive cases. A special problem at our institution is large numbers of foreign patients, so effective use of social resources and interdisciplinary coordination are very important for reliable follow-up in the outpatient clinic.
